Crit Care: The efficacy of corticosteroid therapy in patients with COVID-19

During the current SARS-CoV-2 pandemic, there was worldwide debate about whether COVID-19 patients were using glucoticoids.
a recent RECOVERY trial, researchers evaluated the efficacy of dexamisson and showed a 28-day reduction in mortality in patients who needed oxygen therapy or mechanical aeration.
the results of this study led to consideration of revising the guidelines or actually recommending the use of corticosteroid therapy in COVID-19.
, however, the effectiveness and safety of corticosteroids are not yet clear, and reliable data are needed to further clarify their benefits and harms.
recently, researchers conducted a systematic review and meta-analysis to assess the efficacy and safety of glucoticoid therapy in patients with COVID-19 in a research paper published recently in Critical Care, an authoritative journal in critical care medicine.
according to PRISMA guidelines, from December 1, 2019 to October 1, 2020, researchers systematically searched RCTS literature on Medline, PubMed, Embase, and Web of Science, and conducted observational studies on adult patients.
The main outcome of the study was short-term mortality and virus clearance rates (based on RT-PCR in respiratory specimens), and the secondary outcome was the need for mechanical aeration, additional oxygen therapy, hospitalization time and secondary infections.
the analysis included 44 studies covering 20197 patients.
22 studies, the effects of corticosteroid therapy on patient mortality were quantified.
overall assessment (observational studies and RCT) showed a significant reduction in mortality in the corticosteroid group (OR 0.72 (95% CI 0.57-0.87);
in the standard treatment group, 14 studies on the 24th day showed positive effects on the demand and duration of corticosteroids for mechanical aeration, and showed a trend towards more infections and the use of antibiotics.
results from observational studies and RCT confirmed that corticosteroids have beneficial effects on short-term mortality and reduce the need for mechanical aeration.
, although the data in the study were too sparse to draw any conclusive conclusions, there was a possible risk of delayed virus removal and increased secondary infections.
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